Safe Exercises with Rotator Cuff Injury – 7 Steps to Happier Shoulders
Nothing conjures images of an oddly-angled joint quite like the thought of a shoulder injury. In truth though, shoulder injuries aren’t always that dramatic. The complex nature of the joint means damage can often slowly creep in over time. Rotator cuff injuries are a prime example. Whether you’re swinging a racquet, holding an umbrella, or simply trying to push the door that says ‘pull’, the rotator cuff is the constant driving force behind the motion. It’s also a part of one of the hardest working joints in the body. So finding safe exercises with rotator cuff injury is an essential first step on the road to recovery.
Knowing where to begin however, isn’t always that simple.
We’ll help guide you through everything from anatomy and injury risk, to simple shoulder exercises that you can try in the comfort of your own home.
Ready to get started?
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What is the rotator cuff?
Your shoulder (or glenohumeral) joint, is formed where the top of the upper arm bone (humerus) fits into the shoulder blade (scapula). The head, or ‘ball’, of the humerus rests in a shallow depression known as the glenoid cavity, the ‘socket’ of the shoulder blade.
It’s thanks to this ball and socket joint formation that your shoulders have such an amazing range of motion.
It’s also thanks to this same ball and socket arrangement however, that without any supporting structures, your upper arm would jump out of its assigned seating at any given opportunity. Which quite frankly would be a little inconvenient. Not to mention painful.
It’s here that the rotator cuff steps in.
Your rotator cuff is a group of muscles and adjoining tendons that surround the shoulder. The four muscles work in unison to help control and stabilise the position and movement of your arm and shoulder joint.
The muscles of the rotator cuff, from top to bottom, are:
- Supraspinatus – allows for arm movement away from the body (abduction)
- Infraspinatus – large triangular muscle, allows for external rotation of the shoulder
- Teres minor – small but mighty, also aids in external shoulder rotation
- Subscapularis – largest and strongest muscle, allows for internal rotation of the shoulder
The collective force of the muscles also serves to ‘pull’ the head of the humerus into its socket… and helps keep it there. Fantastic news if you like your joints to stay right where they belong.
Which altogether makes the rotator cuff handy for shoulder stabilisation AND some impressive trivia to tuck away for quiz night.
Unfortunately, the heavy workload of the rotator cuff can also leave it susceptible to injury. In much the same way as you need to modify activity for hip injuries, finding the best rotator cuff exercises also means knowing the activities to perhaps avoid.
But what causes rotator cuff injury?
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What are the risk factors for rotator cuff injury?
Damage to the rotator cuff can be caused by either an acute or degenerative injury process.
The most common rotator cuff injuries include muscle tears, bursitis, and inflammation or impingement (‘pinching’) of the surrounding tendons.
Acute (or traumatic) injuries
Acute rotator cuff injury commonly occurs as the result of a sudden movement or direct impact to the shoulder. Risk factors include high-contact sport, falling on an outstretched arm, or a sudden wrenching force on the joint.
Degenerative (or ‘wear and tear’) injuries
Risk factors for degenerative injuries include:
Age
As we get older, the elastic properties and blood supply in our soft tissues can lessen. A reduction in the body’s natural ability to repair itself leaves us more prone to injuries in later years. Age-related change can also be determined by the choices we make in everyday life. Regular physical activity and a well-balanced diet can help to keep our joints healthier for longer.
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Activities and lifestyle
Repetitive stress and overuse of the shoulder are the most common risk factors for chronic rotator cuff injury. Athletes in sports such as baseball, rowing, tennis, rock climbing and weightlifting are particularly vulnerable to the risk of tears. Those whose work involves regular overhead movements are also prone to the effects of chronic overuse.
In fact, almost any repetitive positioning or overuse of the shoulder has the potential to induce wear and tear. So much so, scientists have even conducted studies into the risk of rotator cuff injury in our sleep!
Which might well beg the question, if simply lying down has its risks, can there really be such a thing as safe exercises with rotator cuff injury?!
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Why are rotator cuff exercises so important?
Conservative treatment is often the preferred approach for rotator cuff injury. The initial aim is to reduce and relieve pain and inflammation. This might mean a combination of rest, painkillers and taking care to avoid any aggravating activities.
However, it’s also important to keep the shoulder moving. Stopping activity altogether runs the risk of muscle weakness and a stiff shoulder joint. In a similar way that exercise is encouraged for arthritis, appropriate activity is necessary to help keep your shoulders healthy.
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Exercise is vital as both an aid to recovery, and to help reduce the risk of injuries in the future.
What are safe exercises with rotator cuff injury?
Shoulder exercises are widely designed to improve your range of motion, flexibility and strength.
Performed daily under the guidance of your medical team, the following exercises can help provide a gentle first step back to recovery from rotator cuff injury.
The great news is, they can all be carried out in the comfort of your own home!
Shoulder exercises to improve mobility
Pendulum exercise
The pendulum uses body weight and momentum to gently encourage your shoulder to move. Begin by standing next to a table, with your feet roughly shoulder-width apart. Rest the hand of your healthy arm on the table and bend forward at the hips, letting your injured arm hang down. Remember to keep your shoulder muscles relaxed and let the rest of your body do the work. Slowly shift your hips in a side to side or circular motion. The momentum will cause your injured arm to swing gently at the same time.
Shoulder shrug and stretch
In addition to working the shoulder, the 2-step shrug and stretch actively targets the scapula muscles. Step one of this standing exercise is to raise your shoulders as if you’re mid-shrug. Hold for a few seconds. Then pull your shoulder blades back and squeeze together. Hold for a further few seconds. Relax.
Exercises to stretch and improve rotator cuff flexibility
Doorway stretch and lean
Place your hands at, or just below, shoulder height on the wall either side of a doorway. Keeping your back straight, slowly lean forward through the doorway until you feel a gentle stretch at the front of your shoulder.
Crossover arm stretch
Bring your injured arm across the front of your chest, as if you’re reaching to the opposite side. Position your healthy arm so that the inside of your forearm rests just above the elbow of the injured side. Now gently pull your good arm towards you. This will stretch your injured arm further across the body and you should feel a stretch at the back of your shoulder.
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Rotator cuff strengthening exercises
Door or wall press
Stand in a doorway with the elbow of your injured arm bent to a right angle. Keeping your elbow bent, press the back (or outside) of your forearm against the wall as if you’re trying to push the wall away from you. Hold for a few seconds and then relax. Repeat the exercise but this time using the inside of your forearm (palm side) to push against the wall. Hold for a few second and then relax.
External rotation (with optional added resistance)
Lie on your side, with your good arm beneath you (so if your shoulder injury is on the left, you need to lie on your right-hand side, and vice versa). Bend your injured arm at the elbow so that your forearm drops across your belly. Keeping your elbow pressed against the body, slowly raise the hand of your injured arm towards the ceiling. Hold for a few seconds and then gently lower your arm to its starting position. Resistance can be increased by holding a light weight if appropriate.
Internal rotation (with optional added resistance)
Lie on your injured side, with the elbow of your injured arm bent to 90 degrees and tucked against your body. The back of your hand should be flat against the floor or surface. Keeping your elbow against your side, slowly lift and bring your hand towards your belly. Hold for a few seconds and then gently lower. Again, resistance can be added if appropriate.
Shoulder injury recovery
As with any injury, it’s important to seek and follow the guidance of your medical team at every stage of your condition, particularly before trying any new physical activity. But with early treatment and regular exercise to keep your joints in tip-top condition, you’ll be right back on track for healthier and happier shoulders.
If you’ve recovered from a shoulder injury and have any tips to share, or perhaps you’re still just recovering from pushing the door that said ‘pull’ and would like to share that too, please let us know with a comment in the section below.
